All of the following are associated with polycystic ovarian syndrome except :
**Core Concept**
Polycystic ovarian syndrome (PCOS) is a complex endocrine disorder characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. The underlying pathophysiology involves insulin resistance, increased androgen production, and abnormal gonadotropin secretion.
**Why the Correct Answer is Right**
The correct answer is associated with PCOS due to its pathophysiological mechanisms. PCOS is characterized by insulin resistance, which is a key factor in the development of the syndrome. Insulin resistance leads to hyperinsulinemia, which in turn stimulates androgen production by ovarian stroma, contributing to the symptoms of PCOS.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because hyperprolactinemia is not directly associated with PCOS. While hyperprolactinemia can cause amenorrhea and galactorrhea, it is a separate endocrine disorder.
**Option B:** This option is incorrect because anovulatory cycles are a hallmark of PCOS, resulting from luteinizing hormone (LH) hypersecretion and insulin resistance.
**Option C:** This option is incorrect because obesity is a common comorbidity of PCOS, often associated with insulin resistance and metabolic syndrome.
**Clinical Pearl / High-Yield Fact**
A key clinical feature of PCOS is the presence of acanthosis nigricans, a skin condition characterized by dark, velvety skin patches, often seen in the neck, armpits, and groin. This finding is a useful clinical clue to the diagnosis of PCOS.
**Correct Answer: D. Hyperprolactinemia**